Renato de Luna, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DE60244473 Issued in WA

Legal business name

RENATO DE LUNA, DMD

Doing business as

DeLuna Kids Dental

Practice address

11700 NE 95TH St
Suite 120
Vancouver, WA 98682-2399

Phone

(360) 735-0222

Fax

(360) 735-0223

NPI assigned

Jan 15, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Rachel Gorman

Title

Manager

Phone

(360) 735-0222

Specialties & licenses 1

Addresses

Other names 1

• DeLuna Kids Dental Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1421280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421280000000",
    "number": "1396134185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11700 NE 95TH ST",
            "address_2": "SUITE 120",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986822399",
            "telephone_number": "360-735-0222",
            "fax_number": "360-735-0223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11700 NE 95TH ST",
            "address_2": "SUITE 120",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986822399",
            "telephone_number": "360-735-0222",
            "fax_number": "360-735-0223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENATO DE LUNA, DMD",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-15",
        "last_updated": "2015-01-15",
        "status": "A",
        "authorized_official_last_name": "GORMAN",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "360-735-0222"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WA",
            "license": "DE60244473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DeLuna Kids Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pediatric Dentistry in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Pediatric Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.